Confocal DNA Cytometry Prostate Cancer- Age & Ethnicity

描述(申请人提供)：共聚焦DNA细胞术使用DNA定量染色的核的3D图像；核DNA含量、大小、形状和染色质纹理被测量并用于得出定量的核等级(QNG)。QNG测量癌症细胞核中的异常，QNG的变化与增加基因组不稳定性和更具侵袭性的肿瘤行为相关。与Gleason评分等已建立的风险标记物相比，QNG可提供重要且独立的预后信息。对于前列腺癌(PCA)，这一信息可能是描述前列腺癌与更普遍的中间Gleason评分(6和7)最有用的。如果前列腺癌的生物学特性随着年龄、种族和民族的不同而不同，QNG应该能检测到这种变化。在不同的临床情况下，有三个方面可能是有用的，这些情况针对受影响个人的年龄或种族/民族：1)检测。分析癌旁正常核团的癌变相关改变可能会提高核心针活检的有效性。2)诊断。QNG可能为补充Gleason分级和病理分期提供额外的独立信息。3)预后。QNG对隐匿性前列腺外扩散、复发和/或治疗反应的预测具有更高的敏感性。恶性肿瘤相关的变化对于了解正常外观细胞随着肿瘤的发展以及随着年龄、种族和民族的发展而发生的渐进性变化非常重要。更仔细的监测，为化学预防研究划定高危队列，以及检测临床上微不足道的癌症，对老年人和年轻人以及不同的种族/民族来说都可能是不同的；这些问题必须得到彻底的探索。QNG检测随着年龄、种族和民族的生物变化的能力也应该得到与增殖、凋亡和/或预后相关的选定分子标记的表型表达的补充。在所有年龄段中，根据针吸活检结果和/或根治性标本的结果预测肿瘤的生物学侵袭性和分期对于临床决策至关重要。我们将使用QNG水平和分子标记来预测基于年龄/种族和民族的PCa的侵袭性。我们将检验负面假设，即在所有其他预后变量相同的情况下，年龄和种族群体与肿瘤侵袭性没有相关性。

DESCRIPTION (provided by applicant): Confocal DNA cytometry uses 3D images of nuclei stained quantitatively for DNA; nuclear DNA content, size, shape, and chromatin texture are measured and used to derive a quantitative nuclear grade (QNG). QNG measures abnormalities in cancer nuclei, and changes in QNG have been correlated to increasing genomic instability and more aggressive tumor behavior. QNG provides significant and independent prognostic information when compared to established markers of risk such as the Gleason Score. With respect to prostate adenocarcinoma (PCa), this information may be most useful in describing PCa with more prevalent intermediate Gleason scores (6 and 7). If the biology of PCa varies with age, race and ethnicity, QNG should detect such changes. Three areas might be useful in different clinical scenarios unique to the age or racial/ethnic groups of the affected individuals: 1) Detection. Analysis of malignancy associated changes in normal appearing nuclei adjacent to carcinomas might enhance the usefulness of core needle biopsies. 2) Diagnosis. QNG might provide additional independent information to supplement Gleason grades and pathologic stages. 3) Prognosis. QNG might allow greater sensitivity for the prediction of occult extraprostatic extension, recurrence and/or responsiveness to therapy. Malignancy associated changes are important in understanding progressive changes in normal appearing cells with the development of neoplasia and with age, race, and ethnicity. More careful surveillance, delineation of high-risk cohorts for chemoprevention studies, and detection of clinically insignificant cancer might all be different for elderly vs. younger men and in different racial/ethnic groups; these issues must be explored thoroughly. The ability of QNG to detect biological changes with age, race and ethnicity also should be complemented by phenotypic expression of selected molecular markers which correlate with proliferation, apoptosis and/or prognosis. In all age groups, predicting the biological aggressiveness and stage of tumors, based on needle biopsy findings and/or on the results of radical specimens, is critical for clinical decision making. We will use the levels of QNG and molecular markers to predict the aggressiveness of PCa based on age/race and ethnicity. We will test the negative hypothesis that age and ethnic groups, with all other prognostic variables being equal, will have no correlation with tumor aggressiveness.